A client at 28-weeks gestation whose hemoglobin level is 10.7 g/dL (107 g/L) and hematocrit is 32% (0.32 volume fraction), tells the nurse that she eats plenty of green vegetables. When the client asks the nurse how the low level value might affect her pregnancy, which information should the nurse provide? Reference range: Hemoglobin 12 to 16 g/dl (120 to 160 g/L): pregnant greater than 11 g/dl (110 g/L) Hematocrit 37% to 47% (0.37 to 0.47 volume fraction): pregnant greater than 33% (0.33 volume fraction)

A. It might be necessary to take an iron supplement twice daily: The client’s hemoglobin (10.7 g/dL) and hematocrit (32%) are slightly below the recommended levels for pregnancy, indicating mild iron-deficiency anemia. Iron supplementation can help restore adequate red blood cell levels and support fetal growth. B. Plasma volume increases, making the blood count appear low: While hemodilution occurs during pregnancy due to increased plasma volume, the client’s values are below the lower limit for pregnant women, suggesting actual anemia rather than just dilution. C. Increasing intake of protein might improve these values: Protein supports hemoglobin production, but iron deficiency is the primary cause of low hemoglobin and hematocrit in pregnancy. Dietary protein alone is insufficient to correct iron-deficiency anemia. D. Almost all women at 28-weeks gestation have anemia: Although mild anemia is common in the second trimester, not all women are anemic. Each case should be evaluated individually to determine the need for supplementation or further intervention.